How much rates vary
Facilitymedian $3,090 · 10th to 90th $708 to $11,482Professionalmedian $2,884 · 10th to 90th $2,291 to $3,467
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,090.30 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,090.30 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,884.03 | $2,951.21 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,884.03 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,819.70 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,548.82 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $457.09 Typical High $562.34 | Professional | 80 · Assistant surgeon | $389.05 | $457.09 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | AS · PA/NP assist | $338.84 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,884.03 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,818.38 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,630.78 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,884.03 | $3,162.28 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,290.87 | $2,398.83 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,951.21 Typical High $10,232.93 | Facility | None | $1,445.44 | $2,951.21 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,818.38 | $3,981.07 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,454.71 | $4,265.80 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 53 · Discontinued | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,137.96 |
Where Virginia sits
The same service costs 7.8 times more in Colorado than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $22,169TX $2,853
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.